The 24-hour urine proteinuria or albuminuria ratio is still prescribed for protein detection in urine, despite the fact that it has been replaced by the albuminuria or protein/creatininuria ratio. The use of this ratio eliminates the misinterpretation of 24-hour urine proteinuria. The objective of this development is to clarify the importance of the ratio for the search for albumin or protein in the urine. We conducted a review of the literature focusing on different diagnostic recommendations. Indeed, 24-hour urine collection is tedious and prone to many errors. The ratio is therefore a simple, reliable and standardized indicator for assessing proteinuria except in acute renal failure patients. The correlation between these ratios and 24-hour urine has been demonstrated in several studies in various populations and is currently considered to be the most adequate measure for proteinuria quantification despite the variability in creatinine excretion. The Kidney Disease Improving Global Outcomes recommendations therefore suggest the use of the albumin/creatinine ratio and the protein/creatinine ratio on a 1st morning urine sample to test for proteinuria.
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